The Career Woman’s Disease

Responding to Lasers for Ladies, Endo Discourse and the Inscriptions for Science, by Ella Shohat

One of the most profound points brought up in this reading was just how greatly a woman’s medical diagnosis can be affected by her race. Shohat tells us that endometriosis is described as a “career woman’s disease… because of its enduring association with the choice not to bear children.” This is interesting for a few reasons, not least of which is the fact that ‘career woman’ is coded as white, heterosexual, and middle class.

Medicine is considered to be an objective science, and all practicing doctors have to take the Hippocratic Oath which includes a clause about treating all people without prejudice. Thus, one would think — or at least hope — that a doctor would treat all bodies without bias. However, the fact that doctors have preconceived notions about bodies, specifically bodies of color, is unethical. Doctors are clearly not treating all bodies equally, instead they are making clear that they value certain bodies over others.

This poses a question: Are these biases innate to the medical profession, or are they perpetuated by (white) doctors who hold racial prejudices and project them onto their patients? What about doctors of color, are they equally as susceptible to prejudicial diagnoses?

I have some friends, who are women of color, who are currently in medical school. They have described to me that they have chosen to specialize in cardiology and neurology, rather than obstetrics and gynecology or pediatrics — despite that being their interest, because they did not want to be perceived as fitting into a stereotype. They wanted to prove to their peers that they were able to take on the ‘serious’, ‘less emotional’ medical challenges like their white and/or male peers. This is unfortunate because these women who would actually be more sympathetic and aware of these discriminatory issues, and have a positive impact on their patients, are being driven away from focusing on women’s health.

Both Emily and I have had many situations where (male and/or white) doctors have tried to minimize our health concerns, specifically related to our reproductive health. For example, when Emily went for a checkup to her white male doctor to discuss her issues with menstrual pains and related symptoms, he responded with “Oh, so you get bitchy around your period?” Aside from being wildly unprofessional, that is an incredibly gendered comment to make. While he might speak casually with male patients, he would never call them ‘bitchy’. Just. Never. It would never come up. By using this word towards Emily, he dismissed her concerns and reduced her to being an ‘emotional female’ stereotype. Although it is an outdated term now, he still thinks of her as being ‘hysterical’.

I have also been to doctors for concerns that I have had around my mental health. I have panic disorder, and at a time was suffering from multiple panic attacks every day. It was debilitating and I was afraid to leave the house for fear of having a panic attack. It was very serious. After doing research online about anxiety I identified a (white, female) psychologist who specialized in treating anxiety disorders. After explaining my problems to her she trivialized my experiences and tried to convince me that I had self-esteem issues. She made it seem that I had little self awareness and education about mental health issues, despite the fact that I have a BA in Psychology. When I explained that I don’t have self esteem problems (which is a weird non-falsifiable statement) she then denied prescribing me medication because “anti-anxiety medications are often abused” — without asking or considering whether or not I, personally, would abuse medication. (I don’t and I haven’t.) She then said that anti-anxiety medication is expensive and alluded to the idea that I would not be able to afford it, again, not knowing my financial situation. I cannot help but feel that my positionality as an immigrant and woman of color affected her treatment of me.

It is striking to see the deeper implications of medical practitioners’ (seemingly) implicit biases, in that they affect the quality of care that patients receive. This makes us think about how simply having physical access to medical care and resources is not enough. In order to ensure that their patients receive equitable treatment, doctors need to work on — in Manning’s terms — becoming.